US20100161049A1 - Intraocular lens insertion device and method for controlling movement of the intraocular lens - Google Patents
Intraocular lens insertion device and method for controlling movement of the intraocular lens Download PDFInfo
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- US20100161049A1 US20100161049A1 US12/667,510 US66751008A US2010161049A1 US 20100161049 A1 US20100161049 A1 US 20100161049A1 US 66751008 A US66751008 A US 66751008A US 2010161049 A1 US2010161049 A1 US 2010161049A1
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- Prior art keywords
- lens
- intraocular lens
- supporting portion
- optic
- insertion device
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1662—Instruments for inserting intraocular lenses into the eye
- A61F2/167—Instruments for inserting intraocular lenses into the eye with pushable plungers
Definitions
- the present invention relates to an intraocular lens insertion device and a method for controlling movement of the intraocular lens used to implant an intraocular lens into an eye in place of a crystalline lens removed in cataract surgery.
- intraocular lens In cataract surgery, there has been widely performed removal of opacified crystalline lenses by phacoemulsification and aspiration (PEA) followed by implantation of intraocular lenses into aphakic eyes.
- PEA phacoemulsification and aspiration
- intraocular lens There are two types of intraocular lens: a hard intraocular lens whose optic is made of a hard material such as PMMA and a soft intraocular lens whose optic is made of a flexible material such as silicone elastomer, soft acrylic or hydrogel.
- the lens Upon use of a hard intraocular lens, the lens needs to be inserted through an incision having been cut in a cornea or sclera in a width approximately the same as the diameter of the optic of the lens. On the other hand, upon use of a soft intraocular lens, the lens can be inserted through an incision smaller than the diameter of the optic of the lens by folding the optic.
- Type 50 whose optic is made of a soft material and supporting portions are made of a hard material such as PMMA (generally, this type of intraocular lens has two thin filament-shaped supporting portions (FIG. 9 (A)); Type 51 whose optic and supporting portions are made of the same soft material (generally, this type of intraocular lens has plate-like supporting portions (FIG. 9 (B)); and Type 52 which has two or more thin plate-like supporting portions ( FIG. 9(C) ).
- a dedicated intraocular lens insertion device having a mechanism to lead an intraocular lens to an eye through a slender tube is used in some cases in order to insert intraocular lenses into eyes.
- an intraocular lens insertion device By using such an intraocular lens insertion device, an intraocular lens can be inserted through an incision opening smaller than 3 mm.
- an intraocular lens insertion device where an intraocular lens is set beforehand and which can be packaged and stored has been developed.
- a supporting portion arranged in the backward direction of a lens advancing axis (hereinafter, referred to as a trailing supporting portion) got caught in the gap between a plunger for pushing out the intraocular lens and an inner wall of a passage of the insertion device or entangled in the plunger in a process of movement of the intraocular lens.
- a problem is brought to the fore especially with a soft intraocular lens having thin filament-shaped supporting portions or a soft intraocular lens having thin plate-like supporting portions.
- the behavior of the trailing supporting portion of intraocular lens needs to be controlled appropriately in a process of movement of the intraocular lens.
- Patent Document 1 a lens insertion tool which has a side clearance provided at the distal end of a plunger for accommodating a trailing supporting portion to prevent damage to the trailing supporting portion
- Patent Document 2 A lens insertion tool provided with a relief channel for a trailing supporting portion at the lower side of a plunger has been also disclosed (Patent Document 2, for example).
- Patent Document 3 a lens insertion tool wherein a plunger pushes a trailing supporting portion up a ramp and bends haptics up and over IOL has been disclosed (Patent Document 3, for example).
- Patent Document 1 Japanese Translation of PCT International Application No. 11-506357
- Patent Document 2 U.S. Pat. No. 6,733,507
- Patent Document 3 Japanese Unexamined Patent Publication No. 2004-351196
- Patent Documents 1 and 2 still have a problem that the trailing supporting portion relieved into a clearance at the distal end of plunger or a relief channel for a trailing supporting portion stretches and the trailing supporting portion is left outside of the incision when the intraocular lens is inserted through a small incision of the eye.
- an intraocular lens having thin plate-like supporting portions which are made of thick soft members has a problem that it takes time and labor to conduct a repeated operation.
- an object of the present invention is to provide an intraocular lens insertion device and an intraocular lens movement control method which can appropriately control the behavior of a trailing supporting portion in a process of movement of the intraocular lens and can reduce the possibility of a repeated operation after insertion of the intraocular lens into an eye.
- the inventor of the present application conducted studies over and over again and found that the above-mentioned object could be achieved by folding an optic and supporting portions individually while minimizing the interference of the optic and the supporting portions during movement of the intraocular lens.
- the invention according to claim 1 features an intraocular lens insertion device comprising: a lens setting part for setting an intraocular lens having an optic and one or two or more supporting portions disposed at the outer edge of the optic; a plunger for pushing out the intraocular lens set on the lens setting part; and a nozzle for releasing the intraocular lens pushed out by the plunger, the intraocular lens being set on the lens setting part with at least one of the supporting portions being arranged in the backward direction of a lens advancing axis, wherein the plunger includes a lens contact portion for abutting against the outer edge of the optic and a pushing portion for pushing out the supporting portion arranged in the backward direction of the lens advancing axis.
- the invention according to claim 2 is characterized in that the pushing portion bends the supporting portion in the forward direction of the lens advancing axis.
- the invention according to claim 3 is characterized in that the pushing portion bends the supporting portion in the forward direction of the lens advancing axis without interference of the optic and the supporting portion.
- the invention according to claim 4 is characterized in that the pushing portion includes a guide extending in the direction of the lens advancing axis.
- the invention according to claim 5 is characterized in that the pushing portion is a groove extending in the direction of the lens advancing axis.
- the invention according to claim 6 is characterized in that the pushing portion includes a supporting portion abutting face for abutting against the deformed supporting portion.
- the invention according to claim 7 features a method for controlling movement of an intraocular lens, comprising the steps of: setting an intraocular lens having an optic and one or two or more supporting portions disposed at the outer edge of the optic on a lens setting part with at least one of the supporting portions being arranged in the backward direction of a lens advancing axis; and moving the intraocular lens in the forward direction of the lens advancing axis, wherein the moving step includes the steps of: pushing out the supporting portion arranged in the backward direction of the lens advancing axis in the lens moving direction; and pushing out the outer edge of the optic in the forward direction of the lens advancing axis.
- the invention according to claim 8 is characterized in that the step of pushing out of the supporting portion comprises a step of bending a tip of the supporting portion in the forward direction of the lens advancing axis.
- the pushing portion provided on the plunger moves an intraocular lens forward with the supporting portion being caught, thereby preventing the supporting portion from stretching backward as the intraocular lens is moving forward. Therefore, with this intraocular lens insertion device, the supporting portions can be inserted together with the optic into an eye through an incision at one operation, thereby omitting a repeated operation after the intraocular lens was inserted into the eye.
- the optic and the supporting portion arranged in the backward direction of the lens advancing axis are prevented from being damaged or broken while the intraocular lens is moving.
- the intraocular lens is moved forward with a minimum of interference of the optic and the supporting portion arranged in the backward direction of the lens advancing axis, thereby preventing the optic and the trailing supporting portion from being damaged or broken while the intraocular lens is moving.
- the supporting portion arranged in the backward direction of the lens advancing axis is prevented from dropping off in a process of movement of the intraocular lens, resulting in a more reliable control of the supporting portion.
- the supporting portion arranged in the backward direction of the lens advancing axis is pushed out by the supporting portion abutting face and can be inserted into the eye, thereby ensuring that a repeated operation after insertion of the lens into the eye can be omitted.
- the supporting portion can be caught with a simple configuration.
- the pushing portion provided on the plunger moves the intraocular lens forward with the supporting portion being caught, thereby preventing the supporting portion from stretching as the intraocular lens moves forward. Therefore, the intraocular lens insertion device enables the supporting portions to be inserted together with the optic into an eye through an incision at one operation. Thus, the intraocular lens insertion device can omit a repeated operation after insertion of the intraocular lens into the eye.
- the supporting portion can be more surely prevented from stretching backward as the intraocular lens moves forward.
- FIG. 1 shows the overall configuration of an intraocular lens insertion device of the present invention.
- FIG. 2 is a perspective view showing the configuration of a cartridge of the same as above.
- FIG. 3 is a perspective view showing the configuration of a main body of the same as above.
- FIG. 4 is a partial perspective view showing the configuration of a plunger of the same as above.
- FIG. 5 is a sectional view showing a state of use of the same as above, in which (A) is a view showing that a plunger abuts against a supporting portion, (B) is a view showing that a plunger catches a supporting portion, and (C) is a view showing that a plunger abuts against an optic.
- FIG. 6 is a sectional view showing a state of use of a modified example of the same as above, in which (A) is a view showing that a plunger abuts against a supporting portion, (B) is a view showing that a plunger catches a supporting portion, and (C) is a view showing that a plunger abuts against an optic.
- FIG. 7 is a view showing a modified example of a plunger of the same as above.
- FIG. 8 is a view showing another modified example of a plunger of the same as above.
- FIG. 9 shows an intraocular lens of the present invention, in which (A) is a view showing a type of intraocular lens having filament-shaped supporting portions, (B) is a view showing a type having a plate-like supporting portion and (C) a view showing a type having thin plate-like supporting portions.
- An intraocular lens insertion device 1 shown in FIG. 1 has a cartridge 2 , a main body 3 and a plunger 4 .
- the cartridge 2 is installed to the main body 3 after an intraocular lens 5 is set on the cartridge.
- the plunger 4 is provided so that it can move in the forward and backward directions of the lens advancing axis A inside the main body 3 .
- the intraocular lens insertion device 1 having such a configuration is generally configured to push out the intraocular lens 5 set in the cartridge 2 by using the plunger 4 and to release the intraocular lens 5 from the end of the cartridge 2 into an eye.
- an intraocular lens insertion device 1 may be made of various materials.
- synthetic resin may be used for all portions of the tool, thereby allowing easy mass production; or metal such as titanium may be used.
- the intraocular lens 5 also has an optic 6 and a pair of thin plate-like supporting portions 7 a , 7 b disposed at the outer edge of the optic 6 .
- forward forward
- backward backward
- the cartridge 2 comprises: a cartridge main body 14 having an insertion opening 10 , a lens setting part 11 , a transition part 12 and a nozzle 13 in the order along the lens advancing axis A; and wing portions 15 , 15 extending from both sides of the cartridge main body 14 .
- an insertion groove 16 which was formed by notching in the direction of the lens advancing axis A is provided.
- a lens setting part 11 is provided in the forward direction of the lens advancing axis A of the lens setting part 11 .
- the transition part 12 is provided in the forward direction of the lens advancing axis A of the lens setting part 11 .
- the inner wall of the transition part 12 has a mortar shape tapering toward the distal end and communicates with a nozzle 13 at the distal end.
- the cartridge main body 14 is formed so that it can move from the lens setting part 11 to the transition part 12 , and then, from the transition part 12 to the nozzle 13 when the intraocular lens 5 mounted on the lens setting part 11 through the insertion opening 10 is pushed by the plunger 4 .
- the nozzle 13 is formed so that it has an outside diameter sized to be inserted into the incision opening (not shown).
- the bore of the cartridge 2 is formed so that it has an oval shape at the insertion opening 10 , converging into a perfect circle toward the proximal end of the nozzle 13 .
- the main body 3 comprises an attachment portion 20 for removably attaching the cartridge 2 , a flange 21 for locking the fingers of the operator, and a tubular body 24 connecting the attachment portion 20 and the flange 21 .
- the attachment portion 20 is provided at the distal end of the main body 3 formed into a semicircle shape and comprises guide passages 22 , 22 for guiding the wing portions 15 , 15 of the cartridge 2 and locking pieces 23 , 23 provided forward of the lens advancing axis A of the guide passages 22 , 22 .
- the locking pieces 23 , 23 are configured so that it can lock the front ends of the wing portions 15 , 15 of the cartridge 2 .
- the flange 21 is provided on the outer surface of the proximal end of the main body 3 .
- the plunger 4 comprises a pushing rod 30 for pushing out the intraocular lens 5 , a pressing portion 31 provided at the proximal end of the pushing rod 30 and a lens contact portion 32 provided at the distal end of the pushing rod 30 .
- This plunger 4 is installed into the main body 3 in such a manner as to move forward or backward along the lens advancing axis A inside the main body 3 .
- the plunger 4 installed into the main body 3 is configured so that the operator can push out the intraocular lens 5 by pushing the pressing portion 31 and bringing the lens contact portion 32 into contact with the intraocular lens 5 mounted on the lens setting part 11 .
- the plunger has a lens contact portion 32 and a pushing portion 33 connected to the lens contact portion 32 at the distal end of the pushing rod 30 .
- the lens contact portion 32 is formed by a vertical plane relative to the lens advancing axis A.
- the pushing portion 33 catches the supporting portion (hereinafter referred to as the trailing supporting portion) 7 b arranged in the backward direction of the lens advancing axis A and moves the trailing supporting portion 7 b together with the optic 6 without separating from the optic 6 .
- the pushing portion 33 is provided on one side of the lens contact portion 32 and comprises a groove 34 extending in the backward direction from the distal end of the pushing rod 30 , guides 35 , 35 provided on both sides of the groove 34 in parallel with the lens advancing axis A, and a supporting portion abutting face 36 .
- the groove 34 has a concave bottom face and connects to the guides 35 , 35 at the opening end of the side face 34 b converging from the opening toward the bottom face 34 a .
- These guides 35 , 35 are provided at both sides of the groove 34 and formed into a columnar shape, and their ends form part of the lens contact portion 32 .
- the supporting portion abutting face 36 is provided so that a deformed trailing supporting portion 7 b can abut against it.
- This supporting portion abutting face 36 is formed with a plane which slants backward as it goes upward from the surface of the groove 34 , and blocks the backward end of the groove 34 .
- the plunger 4 having such a configuration is attached to the main body 3 , as shown in FIG. 1 , by inserting the lens contact portion 32 , first, in the proximal end of the main body 3 and by positioning the lens contact portion 32 at the distal end of the main body 3 and the pressing portion 31 at the proximal end of the main body 3 .
- FIG. 5 The views on the right of FIG. 5 are sectional views of the vicinity of the lens setting part 11 of the cartridge 2 , and the views on the left show each cross section of the right views.
- the intraocular lens 5 folded into two by use of tweezers (not shown) is inserted through the insertion opening 10 , and then the intraocular lens 5 is set on the lens setting part 11 of the cartridge 2 pre-filled with ophthalmic viscoelastic material.
- the intraocular lens 5 is set with a pair of supporting portions 7 a , 7 b arranged in the forward and backward directions, respectively, relative to the optic 6 ( FIG. 5(A) ).
- the intraocular lens 5 is positioned with the folded optic 6 arranged on one side and the proximal ends of the supporting portions 7 a , 7 b arranged on the other side, respectively.
- the tips of the supporting portions 7 a , 7 b hang down on one side as they move in the forward and backward directions across the optic 6 , respectively. Furthermore, the intraocular lens 5 which is folded into two comes into contact with the bore of the cartridge 2 formed into an oval shape, and accordingly, the supporting portions 7 a , 7 b are arranged along the side wall of the bore.
- the cartridge 2 having the intraocular lens 5 mounted on the lens setting part 11 is attached to the attachment portion 20 of the main body 3 by sliding forward of the lens advancing axis A with the wing portions 15 , 15 mounted on the guide passages 22 , 22 and locking the front ends of the wing portions 15 , 15 with the locking pieces 23 , 23 .
- the nozzle portion 13 is first inserted into an eye through the incision opening (not shown) by the operator.
- the plunger 4 moves forward when the operator pushes the pressing portion 31 .
- the lens contact portion 32 provided at the distal end of the pushing rod 30 comes in contact with the tip of the trailing supporting portion 7 b ( FIG. 5(A) ).
- the trailing supporting portion 7 b is positioned along the bore of the cartridge 2 and comes in contact with the trailing supporting portion 7 b at the distal end of the guides 35 , 35 .
- the trailing supporting portion 7 b which is hanging down to one side is bent at its tip in the forward direction ( FIG. 5(B) ).
- the trailing supporting portion 7 b is guided into the central groove 34 by the side face 34 b converging from the opening toward the bottom face 34 a .
- the pushing portion 33 catches the trailing supporting portion 7 b by supporting the tip of the trailing supporting portion 7 b from one side by the groove 34 .
- the plunger 4 by which the trailing supporting portion 7 b was caught at the pushing portion 33 , is pushed further, and the lens contact portion 32 abuts against the outer edge of the intraocular lens 5 and moves the intraocular lens 5 forward ( FIG. 5(C) ).
- the intraocular lens 5 moving in the cartridge 2 is pushed inward by the inner wall of the transition part 12 and folded to a smaller size. In this way, the intraocular lens insertion device 1 releases the compactly folded intraocular lens 5 from the tip of the nozzle 13 .
- the trailing supporting portion 7 b stretches backward. Therefore, by using the conventional intraocular lens insertion device 1 , the trailing supporting portion 7 b is left outside of the incision when the intraocular lens 5 is inserted through a small incision of an eye, and a repeated operation was needed to insert the trailing supporting portion 7 b left outside of the incision into the incision.
- the pushing portion 33 provided on the plunger 4 moves the intraocular lens 5 forward with the trailing supporting portion 7 b being caught, thereby preventing the trailing supporting portion 7 b from stretching backward as the intraocular lens 5 moves forward.
- the intraocular lens insertion device 1 allows the pushing portion 33 to move the intraocular lens 5 without separating the trailing supporting portion 7 b from the optic 6 and enables the trailing supporting portion 7 b and the optic 6 to be inserted into the eye through the incision at one operation. Therefore, the intraocular lens insertion device 1 can omit a repeated operation after the intraocular lens 5 was inserted into the eye.
- the supporting portion abutting face 36 abuts against the trailing supporting portion 7 b .
- the trailing supporting portion 7 b can be inserted into the eye.
- the intraocular lens insertion device 1 can omit a repeated operation more surely after the intraocular lens 5 was inserted into the eye.
- the plunger 4 is provided with a pushing portion 33 for pushing out the trailing supporting portion 7 b , besides a lens contact portion 32 , thereby folding the trailing supporting portion 7 b and the optic 6 , separately. Therefore, the intraocular lens insertion device 1 can move the intraocular lens 5 forward, keeping interference of the trailing supporting portion 7 b and the optic 6 at a minimum level. Thus, the intraocular lens insertion device 1 can reduce interference of the optic 6 and the trailing supporting portion 7 b during movement of the intraocular lens 5 , thereby preventing the optic 6 and the trailing supporting portion 7 b from being damaged or broken.
- the guides 35 , 35 are formed into a columnar shape, and they can guide the trailing supporting portion 7 b in contact with the distal ends of the guides 35 , 35 to the groove 34 without causing damage.
- This pushing portion 33 is formed by the groove 34 , thereby catching the trailing supporting portion 7 b with such a simple structure.
- the groove 34 has a concave bottom face and can guide the trailing supporting portion 7 b in contact with the guides 35 , 35 smoothly in the groove 34 in the center.
- the bottom face of the groove 34 on the pushing portion 33 is formed by a concave face, thereby catching the trailing supporting portion 7 b guided to the groove 34 without causing damage.
- the pushing portion 33 is provided with the guides 35 , 35 , it can prevent the caught trailing supporting portion 7 b from falling off in the process of movement of the intraocular lens 5 and control the trailing supporting portion 7 b with more reliability.
- this cartridge 40 when the side of the bore where the optic 6 of the intraocular lens 5 folded into two is placed is regarded as one side 12 a , the other side 12 b has a smaller width compared to the one side 12 a .
- the right views of FIG. 6 show the cross sections of the vicinity of the lens setting part 11 on the cartridge 40 and the left views show each cross section of the right views.
- the cartridge 40 according to this modified example has a bore whose width of the other side 2 b is smaller than that of the one side 12 a , allowing the trailing supporting portion 7 b to be guided to the groove 34 in the center more easily than the above embodiment.
- the plunger 4 shown in FIG. 7 is different from the above embodiment in the structure of a pushing portion. More specifically, the pushing portion 50 according to this modified example is formed into a rectangular parallelepiped shape defined by a groove 51 and guides 52 , 52 integrally set up on both sides of the groove 34 . The distal ends of the guides 52 , 52 form part of the lens contact portion 32 .
- the bottom face 51 a of the groove 51 is formed by a flat plane, and a pair of guides 52 , 52 formed on both sides of the groove 51 have a rectangular parallelepiped shape. The corners of these guides 52 , 52 are processed into round shape.
- this modified example has a simple shape compared to the above embodiment, it has an effect of omitting a repeated operation after the intraocular lens 5 was inserted into an eye.
- the plunger 60 shown in FIG. 8 is provided with a scooping face 61 at the lens contact portion 32 on the pushing portion 50 shown in FIG. 7 .
- Providing such a scooping face 61 at the lens contact portion 32 can prevent the distal end of the plunger 4 from running on the optic 6 in the process of movement of the intraocular lens 5 .
- the same effect as the above embodiment can be obtained by providing the pushing portion 50 .
- the transition part of the main body has a mortar shape tapering toward the distal end, and the intraocular lens 5 is folded into a small size by passing through the transition part.
- the present invention is not limited to this embodiment, but applies to the main body having a simple cylindrical transition part.
- the supporting portions are thin plates.
- the present invention is not limited to this embodiment, but applies to an intraocular lens having thin filament-shaped supporting portions.
Abstract
Description
- The present invention relates to an intraocular lens insertion device and a method for controlling movement of the intraocular lens used to implant an intraocular lens into an eye in place of a crystalline lens removed in cataract surgery.
- In cataract surgery, there has been widely performed removal of opacified crystalline lenses by phacoemulsification and aspiration (PEA) followed by implantation of intraocular lenses into aphakic eyes. There are two types of intraocular lens: a hard intraocular lens whose optic is made of a hard material such as PMMA and a soft intraocular lens whose optic is made of a flexible material such as silicone elastomer, soft acrylic or hydrogel.
- Upon use of a hard intraocular lens, the lens needs to be inserted through an incision having been cut in a cornea or sclera in a width approximately the same as the diameter of the optic of the lens. On the other hand, upon use of a soft intraocular lens, the lens can be inserted through an incision smaller than the diameter of the optic of the lens by folding the optic.
- In order to reduce the risk of post-surgery corneal astigmatism or infection, insertion of a lens through a small incision is preferable. Consequently, soft intraocular lenses tend to be preferred now. There are three types of soft intraocular lens:
Type 50 whose optic is made of a soft material and supporting portions are made of a hard material such as PMMA (generally, this type of intraocular lens has two thin filament-shaped supporting portions (FIG. 9(A));Type 51 whose optic and supporting portions are made of the same soft material (generally, this type of intraocular lens has plate-like supporting portions (FIG. 9(B)); andType 52 which has two or more thin plate-like supporting portions (FIG. 9(C) ). - In addition, a dedicated intraocular lens insertion device having a mechanism to lead an intraocular lens to an eye through a slender tube is used in some cases in order to insert intraocular lenses into eyes. By using such an intraocular lens insertion device, an intraocular lens can be inserted through an incision opening smaller than 3 mm.
- In recent years, in order to eliminate the possibility of bacterial contamination or operational error in handling intraocular lenses, an intraocular lens insertion device where an intraocular lens is set beforehand and which can be packaged and stored has been developed.
- With such an intraocular lens insertion device, however, there was a problem that a supporting portion arranged in the backward direction of a lens advancing axis (hereinafter, referred to as a trailing supporting portion) got caught in the gap between a plunger for pushing out the intraocular lens and an inner wall of a passage of the insertion device or entangled in the plunger in a process of movement of the intraocular lens. Such a problem is brought to the fore especially with a soft intraocular lens having thin filament-shaped supporting portions or a soft intraocular lens having thin plate-like supporting portions.
- In such an intraocular lens insertion device, if the trailing supporting portion stretches in a process of movement of the intraocular lens, the trailing supporting portion is left outside of the eye when the lens is inserted through a small incision in the eye. Therefore, after the lens is pushed by the plunger, a repeated operation for inserting the trailing supporting portion into the eye is required, and it takes time and labor in surgery. In some cases, while the intraocular lens is moving inside the intraocular lens insertion device, the optic and the trailing supporting portion interfere with each other, resulting in damage or breakage of the optic or the trailing supporting portion.
- Therefore, when an intraocular lens is inserted into an eye using the intraocular lens insertion device, the behavior of the trailing supporting portion of intraocular lens needs to be controlled appropriately in a process of movement of the intraocular lens.
- In view of the foregoing problems, a lens insertion tool which has a side clearance provided at the distal end of a plunger for accommodating a trailing supporting portion to prevent damage to the trailing supporting portion has been disclosed (
Patent Document 1, for example). A lens insertion tool provided with a relief channel for a trailing supporting portion at the lower side of a plunger has been also disclosed (Patent Document 2, for example). Furthermore, a lens insertion tool wherein a plunger pushes a trailing supporting portion up a ramp and bends haptics up and over IOL has been disclosed (Patent Document 3, for example). Thus, the above-mentioned Patent Documents can reduce getting caught of a trailing supporting portion of intraocular lens having thin filament-shaped or plate-like supporting portions. - Patent Document 2: U.S. Pat. No. 6,733,507
- The above-mentioned
Patent Documents - In view of the foregoing problems, an object of the present invention is to provide an intraocular lens insertion device and an intraocular lens movement control method which can appropriately control the behavior of a trailing supporting portion in a process of movement of the intraocular lens and can reduce the possibility of a repeated operation after insertion of the intraocular lens into an eye.
- The inventor of the present application conducted studies over and over again and found that the above-mentioned object could be achieved by folding an optic and supporting portions individually while minimizing the interference of the optic and the supporting portions during movement of the intraocular lens.
- To achieve the above object, the invention according to
claim 1 features an intraocular lens insertion device comprising: a lens setting part for setting an intraocular lens having an optic and one or two or more supporting portions disposed at the outer edge of the optic; a plunger for pushing out the intraocular lens set on the lens setting part; and a nozzle for releasing the intraocular lens pushed out by the plunger, the intraocular lens being set on the lens setting part with at least one of the supporting portions being arranged in the backward direction of a lens advancing axis, wherein the plunger includes a lens contact portion for abutting against the outer edge of the optic and a pushing portion for pushing out the supporting portion arranged in the backward direction of the lens advancing axis. - The invention according to
claim 2 is characterized in that the pushing portion bends the supporting portion in the forward direction of the lens advancing axis. - The invention according to claim 3 is characterized in that the pushing portion bends the supporting portion in the forward direction of the lens advancing axis without interference of the optic and the supporting portion.
- The invention according to
claim 4 is characterized in that the pushing portion includes a guide extending in the direction of the lens advancing axis. - The invention according to
claim 5 is characterized in that the pushing portion is a groove extending in the direction of the lens advancing axis. - The invention according to
claim 6 is characterized in that the pushing portion includes a supporting portion abutting face for abutting against the deformed supporting portion. - The invention according to claim 7 features a method for controlling movement of an intraocular lens, comprising the steps of: setting an intraocular lens having an optic and one or two or more supporting portions disposed at the outer edge of the optic on a lens setting part with at least one of the supporting portions being arranged in the backward direction of a lens advancing axis; and moving the intraocular lens in the forward direction of the lens advancing axis, wherein the moving step includes the steps of: pushing out the supporting portion arranged in the backward direction of the lens advancing axis in the lens moving direction; and pushing out the outer edge of the optic in the forward direction of the lens advancing axis.
- The invention according to claim 8 is characterized in that the step of pushing out of the supporting portion comprises a step of bending a tip of the supporting portion in the forward direction of the lens advancing axis.
- According to the intraocular lens insertion device set forth in
claim 1 of the present invention, the pushing portion provided on the plunger moves an intraocular lens forward with the supporting portion being caught, thereby preventing the supporting portion from stretching backward as the intraocular lens is moving forward. Therefore, with this intraocular lens insertion device, the supporting portions can be inserted together with the optic into an eye through an incision at one operation, thereby omitting a repeated operation after the intraocular lens was inserted into the eye. - According to the intraocular lens insertion device set forth in
claim 2 of the present invention, the optic and the supporting portion arranged in the backward direction of the lens advancing axis are prevented from being damaged or broken while the intraocular lens is moving. - According to the intraocular lens insertion device set forth in claim 3 of the present invention, the intraocular lens is moved forward with a minimum of interference of the optic and the supporting portion arranged in the backward direction of the lens advancing axis, thereby preventing the optic and the trailing supporting portion from being damaged or broken while the intraocular lens is moving.
- According to the intraocular lens insertion device set forth in
claim 4 of the present invention, the supporting portion arranged in the backward direction of the lens advancing axis is prevented from dropping off in a process of movement of the intraocular lens, resulting in a more reliable control of the supporting portion. - According to the intraocular lens insertion device set forth in
claim 5 of the present invention, the supporting portion arranged in the backward direction of the lens advancing axis is pushed out by the supporting portion abutting face and can be inserted into the eye, thereby ensuring that a repeated operation after insertion of the lens into the eye can be omitted. - According to the intraocular lens insertion device set forth in
claim 6 of the present invention, the supporting portion can be caught with a simple configuration. - According to the intraocular lens movement control method set forth in claim 7 of the present invention, the pushing portion provided on the plunger moves the intraocular lens forward with the supporting portion being caught, thereby preventing the supporting portion from stretching as the intraocular lens moves forward. Therefore, the intraocular lens insertion device enables the supporting portions to be inserted together with the optic into an eye through an incision at one operation. Thus, the intraocular lens insertion device can omit a repeated operation after insertion of the intraocular lens into the eye.
- According to the intraocular lens movement control method set forth in claim 8 of the present invention, the supporting portion can be more surely prevented from stretching backward as the intraocular lens moves forward.
-
FIG. 1 shows the overall configuration of an intraocular lens insertion device of the present invention. -
FIG. 2 is a perspective view showing the configuration of a cartridge of the same as above. -
FIG. 3 is a perspective view showing the configuration of a main body of the same as above. -
FIG. 4 is a partial perspective view showing the configuration of a plunger of the same as above. -
FIG. 5 is a sectional view showing a state of use of the same as above, in which (A) is a view showing that a plunger abuts against a supporting portion, (B) is a view showing that a plunger catches a supporting portion, and (C) is a view showing that a plunger abuts against an optic. -
FIG. 6 is a sectional view showing a state of use of a modified example of the same as above, in which (A) is a view showing that a plunger abuts against a supporting portion, (B) is a view showing that a plunger catches a supporting portion, and (C) is a view showing that a plunger abuts against an optic. -
FIG. 7 is a view showing a modified example of a plunger of the same as above. -
FIG. 8 is a view showing another modified example of a plunger of the same as above. -
FIG. 9 shows an intraocular lens of the present invention, in which (A) is a view showing a type of intraocular lens having filament-shaped supporting portions, (B) is a view showing a type having a plate-like supporting portion and (C) a view showing a type having thin plate-like supporting portions. - Hereinafter, a preferred embodiment of the present invention will be described with reference to the accompanying drawings.
- An intraocular
lens insertion device 1 shown inFIG. 1 has acartridge 2, a main body 3 and aplunger 4. Thecartridge 2 is installed to the main body 3 after anintraocular lens 5 is set on the cartridge. On the other hand, theplunger 4 is provided so that it can move in the forward and backward directions of the lens advancing axis A inside the main body 3. The intraocularlens insertion device 1 having such a configuration is generally configured to push out theintraocular lens 5 set in thecartridge 2 by using theplunger 4 and to release theintraocular lens 5 from the end of thecartridge 2 into an eye. - For reference's sake, an intraocular
lens insertion device 1 may be made of various materials. For example, synthetic resin may be used for all portions of the tool, thereby allowing easy mass production; or metal such as titanium may be used. Theintraocular lens 5 also has anoptic 6 and a pair of thin plate-like supportingportions optic 6. - Hereinafter, each configuration will be described in detail. In the description below, the forward direction of the lens advancing axis A is simply referred to as “forward” and the backward direction of the lens advancing axis A is simply referred to as “backward”.
- As shown in
FIG. 2 , thecartridge 2 comprises: a cartridgemain body 14 having aninsertion opening 10, alens setting part 11, atransition part 12 and anozzle 13 in the order along the lens advancing axis A; andwing portions main body 14. At theinsertion opening 10, aninsertion groove 16 which was formed by notching in the direction of the lens advancing axis A is provided. In the forward direction of the lens advancing axis A of theinsertion opening 10, alens setting part 11 is provided. In the forward direction of the lens advancing axis A of thelens setting part 11, thetransition part 12 is provided. The inner wall of thetransition part 12 has a mortar shape tapering toward the distal end and communicates with anozzle 13 at the distal end. With this configuration, the cartridgemain body 14 is formed so that it can move from thelens setting part 11 to thetransition part 12, and then, from thetransition part 12 to thenozzle 13 when theintraocular lens 5 mounted on thelens setting part 11 through theinsertion opening 10 is pushed by theplunger 4. Thenozzle 13 is formed so that it has an outside diameter sized to be inserted into the incision opening (not shown). The bore of thecartridge 2 is formed so that it has an oval shape at theinsertion opening 10, converging into a perfect circle toward the proximal end of thenozzle 13. - As shown in
FIG. 3 , the main body 3 comprises anattachment portion 20 for removably attaching thecartridge 2, aflange 21 for locking the fingers of the operator, and atubular body 24 connecting theattachment portion 20 and theflange 21. Theattachment portion 20 is provided at the distal end of the main body 3 formed into a semicircle shape and comprises guidepassages wing portions cartridge 2 and lockingpieces guide passages pieces wing portions cartridge 2. Theflange 21 is provided on the outer surface of the proximal end of the main body 3. - Next, a
plunger 4 which is a characteristic component of the present invention will be described in detail. As shown inFIG. 1 , theplunger 4 comprises a pushingrod 30 for pushing out theintraocular lens 5, apressing portion 31 provided at the proximal end of the pushingrod 30 and alens contact portion 32 provided at the distal end of the pushingrod 30. Thisplunger 4 is installed into the main body 3 in such a manner as to move forward or backward along the lens advancing axis A inside the main body 3. Theplunger 4 installed into the main body 3 is configured so that the operator can push out theintraocular lens 5 by pushing thepressing portion 31 and bringing thelens contact portion 32 into contact with theintraocular lens 5 mounted on thelens setting part 11. - As shown in
FIG. 4 , the plunger has alens contact portion 32 and a pushingportion 33 connected to thelens contact portion 32 at the distal end of the pushingrod 30. - The
lens contact portion 32 is formed by a vertical plane relative to the lens advancing axis A. The pushingportion 33 catches the supporting portion (hereinafter referred to as the trailing supporting portion) 7 b arranged in the backward direction of the lens advancing axis A and moves the trailing supportingportion 7 b together with theoptic 6 without separating from theoptic 6. The pushingportion 33 is provided on one side of thelens contact portion 32 and comprises agroove 34 extending in the backward direction from the distal end of the pushingrod 30, guides 35,35 provided on both sides of thegroove 34 in parallel with the lens advancing axis A, and a supportingportion abutting face 36. In this embodiment, thegroove 34 has a concave bottom face and connects to theguides side face 34 b converging from the opening toward thebottom face 34 a. These guides 35,35 are provided at both sides of thegroove 34 and formed into a columnar shape, and their ends form part of thelens contact portion 32. The supportingportion abutting face 36 is provided so that a deformedtrailing supporting portion 7 b can abut against it. This supportingportion abutting face 36 is formed with a plane which slants backward as it goes upward from the surface of thegroove 34, and blocks the backward end of thegroove 34. - The
plunger 4 having such a configuration is attached to the main body 3, as shown inFIG. 1 , by inserting thelens contact portion 32, first, in the proximal end of the main body 3 and by positioning thelens contact portion 32 at the distal end of the main body 3 and thepressing portion 31 at the proximal end of the main body 3. - Next, the operation and effect of the above-mentioned intraocular
lens insertion device 1 will be described with reference to the accompanying drawings. The views on the right ofFIG. 5 are sectional views of the vicinity of thelens setting part 11 of thecartridge 2, and the views on the left show each cross section of the right views. - First, the
intraocular lens 5 folded into two by use of tweezers (not shown) is inserted through theinsertion opening 10, and then theintraocular lens 5 is set on thelens setting part 11 of thecartridge 2 pre-filled with ophthalmic viscoelastic material. At this time, theintraocular lens 5 is set with a pair of supportingportions FIG. 5(A) ). Theintraocular lens 5 is positioned with the foldedoptic 6 arranged on one side and the proximal ends of the supportingportions portions optic 6, respectively. Furthermore, theintraocular lens 5 which is folded into two comes into contact with the bore of thecartridge 2 formed into an oval shape, and accordingly, the supportingportions - Next, the
cartridge 2 having theintraocular lens 5 mounted on thelens setting part 11 is attached to theattachment portion 20 of the main body 3 by sliding forward of the lens advancing axis A with thewing portions guide passages wing portions pieces - After the
cartridge 2 is attached to the main body 3, thenozzle portion 13 is first inserted into an eye through the incision opening (not shown) by the operator. - On the other hand, the
plunger 4 moves forward when the operator pushes thepressing portion 31. When theplunger 4 moves forward, thelens contact portion 32 provided at the distal end of the pushingrod 30 comes in contact with the tip of the trailing supportingportion 7 b (FIG. 5(A) ). At this time, the trailing supportingportion 7 b is positioned along the bore of thecartridge 2 and comes in contact with the trailing supportingportion 7 b at the distal end of theguides - Furthermore, when the
plunger 4 is pushed and thelens contact portion 32 moves forward, the trailing supportingportion 7 b which is hanging down to one side is bent at its tip in the forward direction (FIG. 5(B) ). At the same time, the trailing supportingportion 7 b is guided into thecentral groove 34 by theside face 34 b converging from the opening toward thebottom face 34 a. In this way, the pushingportion 33 catches the trailing supportingportion 7 b by supporting the tip of the trailing supportingportion 7 b from one side by thegroove 34. - The
plunger 4, by which thetrailing supporting portion 7 b was caught at the pushingportion 33, is pushed further, and thelens contact portion 32 abuts against the outer edge of theintraocular lens 5 and moves theintraocular lens 5 forward (FIG. 5(C) ). Theintraocular lens 5 moving in thecartridge 2 is pushed inward by the inner wall of thetransition part 12 and folded to a smaller size. In this way, the intraocularlens insertion device 1 releases the compactly foldedintraocular lens 5 from the tip of thenozzle 13. - In the conventional intraocular
lens insertion device 1, as theintraocular lens 5 moves forward, the trailing supportingportion 7 b stretches backward. Therefore, by using the conventional intraocularlens insertion device 1, the trailing supportingportion 7 b is left outside of the incision when theintraocular lens 5 is inserted through a small incision of an eye, and a repeated operation was needed to insert the trailing supportingportion 7 b left outside of the incision into the incision. - In contrast, in the intraocular
lens insertion device 1 according to this embodiment, the pushingportion 33 provided on theplunger 4 moves theintraocular lens 5 forward with the trailing supportingportion 7 b being caught, thereby preventing the trailing supportingportion 7 b from stretching backward as theintraocular lens 5 moves forward. Thus, the intraocularlens insertion device 1 allows the pushingportion 33 to move theintraocular lens 5 without separating the trailing supportingportion 7 b from theoptic 6 and enables the trailing supportingportion 7 b and theoptic 6 to be inserted into the eye through the incision at one operation. Therefore, the intraocularlens insertion device 1 can omit a repeated operation after theintraocular lens 5 was inserted into the eye. - In addition, the supporting
portion abutting face 36 abuts against the trailing supportingportion 7 b. By pushing out the trailing supportingportion 7 b by the supportingportion abutting face 36, the trailing supportingportion 7 b can be inserted into the eye. Thus, the intraocularlens insertion device 1 can omit a repeated operation more surely after theintraocular lens 5 was inserted into the eye. - As mentioned above, the
plunger 4 is provided with a pushingportion 33 for pushing out the trailing supportingportion 7 b, besides alens contact portion 32, thereby folding the trailing supportingportion 7 b and theoptic 6, separately. Therefore, the intraocularlens insertion device 1 can move theintraocular lens 5 forward, keeping interference of the trailing supportingportion 7 b and theoptic 6 at a minimum level. Thus, the intraocularlens insertion device 1 can reduce interference of theoptic 6 and the trailing supportingportion 7 b during movement of theintraocular lens 5, thereby preventing theoptic 6 and the trailing supportingportion 7 b from being damaged or broken. - As mentioned above, in this embodiment, the
guides trailing supporting portion 7 b in contact with the distal ends of theguides groove 34 without causing damage. - This pushing
portion 33 is formed by thegroove 34, thereby catching the trailing supportingportion 7 b with such a simple structure. Also, thegroove 34 has a concave bottom face and can guide thetrailing supporting portion 7 b in contact with theguides groove 34 in the center. - In addition, the bottom face of the
groove 34 on the pushingportion 33 is formed by a concave face, thereby catching the trailing supportingportion 7 b guided to thegroove 34 without causing damage. - Furthermore, as the pushing
portion 33 is provided with theguides portion 7 b from falling off in the process of movement of theintraocular lens 5 and control the trailing supportingportion 7 b with more reliability. - The difference between the
cartridge 40 shown inFIG. 6 and the above embodiment lies in only the bore shape. With regard to thiscartridge 40, when the side of the bore where theoptic 6 of theintraocular lens 5 folded into two is placed is regarded as oneside 12 a, theother side 12 b has a smaller width compared to the oneside 12 a. The right views ofFIG. 6 show the cross sections of the vicinity of thelens setting part 11 on thecartridge 40 and the left views show each cross section of the right views. - In this modified example, when the operator pushes the
pressing portion 31, theplunger 4 moves forward and thelens contact portion 32 provided at the distal end of the pushingrod 30 abuts against the tip of the trailing supportingportion 7 b (FIG. 6(A) ). The trailing supportingportion 7 b is pushed by the inner wall of theother side 12 b in the bore of thecartridge 40 having a smaller width compared with the oneside 12 a which is the side of theoptic 6 of theintraocular lens 5 placed on the cartridge and is placed in the vicinity of the center of the bore. As a result, the trailing supportingportion 7 b comes in contact with the center of the pushingportion 33, that is, thegroove 34. - When the
plunger 4 is pushed further and thelens contact portion 32 moves forward, the trailing supportingportion 7 b hanging down to the oneside 12 a is bent in the forward direction at its tip (FIG. 6(B) ). At the same time, the trailing supportingportion 7 b is guided into thegroove 34 in the center by theside face 34 b converging from the opening toward thebottom face 34 a. In this way, the pushingportion 33 catches the trailing supportingportion 7 b by supporting the tip of the trailing supportingportion 7 b from the oneside 12 a by thegroove 34. - When the
plunger 4 which caught thetrailing supporting portion 7 b at the pushingportion 33 is further pushed, thelens contact portion 32 abuts against the outer edge of theintraocular lens 5 and theintraocular lens 5 is moved forward (FIG. 6(C) ). In this way, thecartridge 40 according to this modified example has a bore whose width of the other side 2 b is smaller than that of the oneside 12 a, allowing the trailing supportingportion 7 b to be guided to thegroove 34 in the center more easily than the above embodiment. - The
plunger 4 shown inFIG. 7 is different from the above embodiment in the structure of a pushing portion. More specifically, the pushingportion 50 according to this modified example is formed into a rectangular parallelepiped shape defined by agroove 51 and guides 52,52 integrally set up on both sides of thegroove 34. The distal ends of theguides lens contact portion 32. The bottom face 51 a of thegroove 51 is formed by a flat plane, and a pair ofguides groove 51 have a rectangular parallelepiped shape. The corners of theseguides intraocular lens 5 was inserted into an eye. - In addition, the
plunger 60 shown inFIG. 8 is provided with a scoopingface 61 at thelens contact portion 32 on the pushingportion 50 shown inFIG. 7 . Providing such ascooping face 61 at thelens contact portion 32 can prevent the distal end of theplunger 4 from running on theoptic 6 in the process of movement of theintraocular lens 5. In this modified example, the same effect as the above embodiment can be obtained by providing the pushingportion 50. - The present invention is not limited to the embodiment described above, and various modifications can be made thereto within the scope of the present invention. For example, in the above-mentioned embodiment, the transition part of the main body has a mortar shape tapering toward the distal end, and the
intraocular lens 5 is folded into a small size by passing through the transition part. The present invention, however, is not limited to this embodiment, but applies to the main body having a simple cylindrical transition part. - According to the above-mentioned embodiment, the supporting portions are thin plates. The present invention, however, is not limited to this embodiment, but applies to an intraocular lens having thin filament-shaped supporting portions.
Claims (8)
Applications Claiming Priority (2)
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JP2007182535A JP5086713B2 (en) | 2007-07-11 | 2007-07-11 | Intraocular lens insertion device |
PCT/JP2008/062382 WO2009008441A1 (en) | 2007-07-11 | 2008-07-09 | Intraocular lens inserting tool, and intraocular lens movement control method |
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PCT/JP2008/062382 A-371-Of-International WO2009008441A1 (en) | 2007-07-11 | 2008-07-09 | Intraocular lens inserting tool, and intraocular lens movement control method |
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US14/812,104 Continuation US9907647B2 (en) | 2007-07-11 | 2015-07-29 | Intraocular lens insertion device and method for controlling movement of the intraocular lens |
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US14/812,104 Active US9907647B2 (en) | 2007-07-11 | 2015-07-29 | Intraocular lens insertion device and method for controlling movement of the intraocular lens |
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Also Published As
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EP2177178A4 (en) | 2014-03-12 |
JP5086713B2 (en) | 2012-11-28 |
EP2177178A1 (en) | 2010-04-21 |
SG183003A1 (en) | 2012-08-30 |
EP2177178B1 (en) | 2022-09-07 |
US20160113759A1 (en) | 2016-04-28 |
JP2009018009A (en) | 2009-01-29 |
WO2009008441A1 (en) | 2009-01-15 |
US9114006B2 (en) | 2015-08-25 |
US9907647B2 (en) | 2018-03-06 |
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